1CategoriesAdrenal Health Functional Medicine Hormones
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Can Adrenal Insufficiency Lead to Metabolic Disease?

EVIDENCE BASED!

In the always-on-the-go, over-caffeinated, fast food society we live in these days, it’s no surprise that an estimated 80% of Americans suffer from adrenal insufficiency.  Adrenal glands, also known as suprarenal glands, are small, triangular-shaped glands located on top of both kidneys. Adrenal glands produce hormones that help regulate your metabolism, immune system, blood pressure, response to stress, and other essential functions (1).  

Adrenal Hormones and the Way You Feel

Each zone of the adrenal gland secretes a specific hormone. James L. Wilson, Ph.D., who coined the term “adrenal fatigue” in his book Adrenal Fatigue: The 21st Century Syndrome discovered that these tiny glands produce around 50 separate hormones (2).  Along with those hormones comes two that give you a little boost to get through the tough times: adrenaline, the fight-or-flight hormone, and cortisol, the stress hormone. Once your body depletes that rush of adrenaline and cortisol, much like a little child on a sugar rush, your body crashes and the effects of adrenal fatigue set in.  There are warning signs that you are experiencing adrenal fatigue. More than just being “tired”, look for that mid-afternoon slump that can usually only be treated by a cup of coffee or a candy bar— a sign of blood sugar crashing. Other negative adrenal responses include:

  • Brain fog, cloudy-headedness, and mild depression
  • Low thyroid function
  • Blood sugar imbalances, such as hypoglycemia
  • Fatigue – especially morning and mid-afternoon fatigue
  • Sleep disruption
  • Low blood pressure
  • Lowered immune function
  • Inflammation (3)

All About: Cortisol

Cortisol plays a unique role in your overall well being. This glucocorticoid hormone controls the sleep/wake cycle, helps control the body’s use of fats, proteins, and carbohydrates, helps to suppress inflammation, helps regulate blood pressure, and works to increase blood sugar. High levels of stress over an extended period of time result in the prolonged release of cortisol into the bloodstream. Cortisol can trigger an adrenaline response to deal with the stress which triggers triglycerides, thereby boosting “bad” cholesterol, raising blood pressure and blood sugar (4). This prolonged rise in metabolic factors are some of the most common risk factors for heart disease (5). It is my belief that this is why chronic stress can lead to an unfortunate cardiac event like a heart attack or stroke.

Final Thoughts on Adrenal Insufficiency

During the evolution of man, the release of adrenal hormones was essential for survival. The hunter-gatherers were literally running from tigers every day. But in today’s busy, tech-driven world, we are smart enough to know that there are negative consequences to prolonged stress. Ensuring that you have stress management techniques in place is essential to longevity. I have five simple steps you can follow to regulate cortisol here.

1234CategoriesAdrenal Health Functional Medicine Hormones Mental Health
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No, it’s Not in Your Head – You Have Adrenal Fatigue

EVIDENCE BASED!

If you’ve been following me for any length of time you know that twenty years ago I was a NYC commuter working in corporate America.  I spent three to four hours per day on trains and subways and my ten hour days were fueled by obnoxiously large lattes.

I had endless health issues at this time.  But “adrenal fatigue,” was not one of my diagnoses.  In fact, they were: anxiety, depression, brain fog, insomnia, amenorrhea, chronic sinusitis and severe allergies.

But how did I really feel? Burned out.  Literally sick and tired of feeling “sick and tired.” But, I was a good patient.  I always did what my doctors told me to until I had a horrific drug interaction which derailed me and left me questioning “how can all of this medication be helping me?” At this point, still in my twenties and a decade away from my holistic doctorate, I began seeing a chiropractor for a shoulder injury. 

Connecting Adrenal Fatigue to “Burn-out” 

“Your adrenals are flared,” my chiropractor said, “we can rehab your shoulder but it will only get you so far because you need to heal your adrenal glands and see a Chinese Herbalist immediately.”  Now this was COMPLETELY off-the-wall, but remember – I’m a good patient. 

Following doctors orders I saw an herbalist who always yelled at me when I walked into her back room (which was subsequently at the back of an Asian fish market in urban NJ) “You on fi-yah!” she screamed.  And quickly she got together the herbs I would steep and drink three times a day and return in two weeks.  This went on for months.

Once my shoulder tear healed (without surgery) my chiropractor told me that that I should ditch my fast-paced corporate lifestyle and explore chiropractic as a career.  I had an identity working for so many years in NYC that it never dawned on me that my career didn’t agree with me.  Once I committed to doing an about-face and changing my entire life, I began to finally recover from adrenal dysregulation.  And I’m still a work-in-progress.

I believe women bear more work-related stress than men, because they also manage a home, with or without children.  Because of this level of emotional stress, adrenal fatigue may very well be the most common hormonal imbalance in women today.

Your adrenal glands are two pearl-sized triangular organs that sit perfectly on top of each kidney. (1) They produce the stress hormones: cortisol and DHEA. 

I believed I produced way too much of these hormones for years.  I was always “tired” but couldn’t rest well because I was truly “wired.”  I craved sugar and started to develop a “flat-tire/muffin-top” around my midsection.

After practicing for a few years I noticed the symptoms from ten years prior slowly starting to creep back into my life.  The Chinese Herbalist that I had trusted and loved, retired, so I began researching Adrenal Fatigue and stumbled upon Dr. Sara Gottfried’s book: The Hormone Cure. (2) As a Harvard trained OB/GYN and women’s hormone expert, Dr. Gottfried devised a comprehensive list of the symptoms associated with Adrenal Fatigue. (3) 

Symptoms of Adrenal Fatigue: a Comprehensive List 

  • Anxiety, especially in stressful situations
  • Moodiness
  • Emotional instability or excessive emotions
  • Frequent screaming or yelling
  • Confusion, difficulty with focus, under stress
  • Poor resilience to stress – stress feels too much or unfair
  • Excessive sensitivity to human suffering
  • Irritability
  • Negativism
  • Feeling of victimhood
  • Accusatory (more common in men) or quarrelsome
  • Sharp, verbal retorts
  • Energy: fatigue, especially under stress
  • Skin: inflamed such as with rashes, eczema or psoriasis
  • Autoimmune: predisposed to Hashimoto’s or connective tissue disease
  • Food: sugar cravings, intense hunger, salty food cravings

When You Feel Depleted Because You Are

For me, feelings of sadness, diagnosed as depression and barely getting through each day feeling as though my nerves were completely “shot” was actually the late stage of Adrenal Fatigue.  After the adrenal glands spent so many years firing stress hormones, they were in fact depleted, and so was I. 

On the surface, I looked like I had it all together, but inside I was burned-out.  And every so often the signs will start to creep up again so I have to pay very close attention to my alcohol and sugar consumption (because red wine and sweets comfort me). 

When I transitioned from chiropractic to functional medicine seven years ago I realized I was not alone.  In fact, to this day, Adrenal Dysregulation and Fatigue are among the most common diagnoses of women over the age of thirty in my virtual practice.  And through each patient case I’ve been able refine my protocol and assist each women on the path to recovery.

Mistakes Women with Adrenal Fatigue Commonly Make

  1. Minimizing symptoms – much like “putting on a brave face” daily and telling everyone that you’re “fine”; or, simply blowing off those symptoms and correlating them to aging, or a recent event, etc.
  2. Using caffeine, alcohol & sugar to comfort and uplift
  3. “Motoring forward” thinking that eventually everything will return to normal

Final Thoughts on Adrenal Fatigue 

If you relate to three or more of the symptoms of Adrenal Fatigue then maybe it is time to start a diary.  Much like a “food diary” you are recording your experiences and symptoms when you are aware of them.  When I was honest with myself about my fast-paced lifestyle, things became suddenly VERY real when they were all down on paper.  And the documentation process also served as the validation I needed to know it wasn’t “all in my head” and I had a tangible health challenge to work on.

For more on how to address adrenal gland health click here.

fogCategoriesAdrenal Health D.I.Y Remedies Functional Medicine Hormones Mental Health Nutrition
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Brain Fog and 3 Natural Remedies to Start Today

EVIDENCE BASED!

About fifteen years ago I went to a doctor for “brain fog,” and was told “it’s all in your head.  There is simply no such diagnosis.  You need more sleep.” And just like that I walked out of that office with a prescription for sleep medication.  Which I tried once and had the most restless sleep (almost “fake sleep”) I could barely function the next day.

It would be another decade before I knew anything about “health” – let alone brain health.  My life at that time was stressful and fast-paced; I travelled significantly for my corporate job.  I ate all my meals out of the home, drank way too much coffee and diet soda and justified my habits by “spinning myself silly” with daily 5am spin classes.

Fast forward to a career in holistic healthcare and I finally had an explanation for my lack of inspiration, anxiety, and depression: brain fog.  Research out of Switzerland states that chronic fatigue syndrome leads to a decrease in brain blood flow and one or more of the following symptoms (1):

Symptoms of Brain Fog

• Slow thinking
• Difficulty focusing
• Confusion
• Lack of concentration
• Forgetfulness
• Haziness in thought processes

The vicious cycle that exists between insomnia, brain fog and mood swings feel frustrating to say the least. For me, resolving one symptom pharmaceutically exacerbated the others and I felt like I was in a hamster wheel.

Causes of Brain Fog

The good news is that if you sleep well (at least seven hours of uninterrupted sleep each night) and are not dealing with any other symptoms other than brain fog, the best place to start is the diet.  Brain health is greatly affected by refined sugar, alcohol, and refined carbohydrates.  My patients who experience brain fog without insomnia or mood swings respond quickly and efficiently to eliminating these foods for a length of time and slowly reintroducing them to determine which causes the symptoms to return.

But for my patients who experience brain fog in addition to insomnia and mood swings, chances are the H-P-A-T axis may be over-activated.  The Hypothalamus-Pituitary-Adrenal-Thyroid axis is responsible for regulating your stress response, digestion, energy, sex drive, mood and emotions.(2)  Insomnia and sleep deprivation activate your stress response and increase cortisol production from the adrenal glands.(3)  The insomnia piece to the puzzle has very real consequences like: cognitive issues, i.e. brain fog. 

Your brain and body rely on balance between the hormones produced by the H-P-A-T axis.  For example, stressful life events cause a spike in cortisol and carbohydrate depleting which causes serotonin to dip low.  Restoring the delicate balance between the hormones produced by the H-P-A-T axis puts things back on track to significantly reducing and eliminating symptoms.

Natural Remedies

1. Assess Protein and Good Fat Intake

Grass-fed beef and organic poultry are great sources of essential amino acids (proteins we do not produce on our own and need to consume within the diet) which fuel the brain so it can continue to release the exact neurotransmitters (the brain chemicals that stimulate body processes and certain hormone production) you need throughout the day.

Wild-caught fish, free-range eggs and most nuts and seeds are great sources of Omega-3 fatty acids while medium chain triglycerides like coconut oil are also great sources of healthy fat.  These good fats reduce inflammation systemically and assist the body in producing the hormones needed to be joyful and satisfied.  And since nearly more than half your brain is comprised of fat, good fats are absolutely non-negotiable to keep cognitive issues like brain fog, away.(4)

Determining the appropriate amount of daily protein and fat intake varies person to person and initially calculating your macros with a health professional can enable you to zero in on the percentages right for you.  However, in my functional diagnostic medicine practice, I find patients respond well to consuming around 35% protein and around 35% healthy fat of their total daily food intake.

2. Eliminate Refined Sugar and Incorporate Natural Carbohydrates

Processed, fast and convenience foods are extremely high in refined sugar (which is why they are palatable and addictive).  You may initially feel as though you are “clear-headed” with a boost of energy but over time, consuming foods that contain refined sugar and also artificial sugar increase systemic inflammation and contributes to conditions known as “leaky-gut,” (read more on that here). Eating complex, unprocessed carbohydrates throughout the day does the complete opposite! Foods like sweet potatoes, fruit, ancient grains, and raw dairy improve focus and reduce inflammation.   

As mentioned before, calculating your personal macros is very smart to zero in exactly where you need to be daily, but I find most patients in my practice respond well to consuming around 30% of healthy carbohydrates of their total daily food intake. 

3. Find a Stress Management Technique that You will Stick With

It seems like these days we are always “connected” to devices and technology and less connected to real people and experiences that bring us joy.  To decrease the activity of the H-P-A-T axis and decrease symptoms like brain fog, establishing a “go-to” stress management technique is necessary.  If meditation or prayer does not work for you, low-impact exercise like walking or yoga, even journaling or reading may reduce stress.  Personally, I feel most relaxed in nature.  Find what works for you and commit to utilizing it daily.

hpaCategoriesAdrenal Health Functional Medicine Hormones
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Adrenal Fatigue and the HPA-axis

I can’t tell you how many messages I still receive on a regular basis from people asking me “if I was aware that Adrenal Fatigue is not real.” My answer is always the same: Just because it does not have a medical diagnosis, doesn’t mean it’s not real. Adrenal Fatigue is the “umbrella term” that functional medicine practitioners use to describe the symptoms patient’s experience when there is HPA-Axis Dysfunction (more on that in a second).

Diagnosing the Root Cause

The truth is, I medically diagnose the exact issue.  For example, a patient who presents to my clinic with salt cravings, afternoon fatigue and the consistent inability to “not be able to get going in the morning,” I lean towards “under-active adrenal glands.”  Upon confirmation through functional lab testing, that patient will receive a diagnosis of “E27.40 – Adrenal Gland Insufficiency.” (This is not to be confused with Addison’s Disease, which is late-end stage adrenal insufficiency and a very serious condition.)

 

What is the HPA-axis?

The HPA-axis is a network of communication, “signals” that exist between the hypothalamus, the pituitary gland and the adrenal glands. This network is responsible for how we respond to stress and we therefore, can not survive without it.  When neurotransmitters from your brain (hypothalamus) don’t communicate well with your endocrine system (pituitary gland and adrenal glands), due to chronic stress, illness, etc., your adrenal glands can begin to over-produce or under-produce the hormones we rely on daily.  If left unaddressed, the adrenal glands become “fatigued,” and boy – do we feel it! Therein lies how functional practitioners coined the term, “Adrenal Fatigue Syndrome.” The signals of the HPA-axis are utilized by virtually every cell and physiological system of the body to optimize performance according to circadian, environmental and physiological demands. Disturbances in normal HPA-axis activity are associated with a wide variety of physiological and mental health disorders. (1)

 

The Stress Response

Simply put, it all beigns with a “stressor.”  It could be anything from a moment of actual physical danger (like running from a tiger), to the nervous joy about an upcoming wedding, all the way over to worry about a job interview.  What happens next is complex but pretty neat (if you ask me):

  1. Your brain (hypothalamus) releases a neurotransmitter to signal the endocrine system (pituitary gland) that it’s “Go-Time”
  2. Next, the endocrine system begins it’s role in your stress response by the pituitary gland releasing a neuromodulator to signal the adrenals glands to produce cortisol and release adrenaline (epinephrine)
  3. Cortisol raises blood sugar
  4. Adrenaline raises your heart rate and increases your blood pressure

 

When Cortisol Takes Over

In the case of adrenal fatigue, the body is in a constant state of fight or flight, and the adrenals are continuously pumping cortisol into your bloodstream. The abundance of cortisol alters leads to hormonal imbalances and a depressed immune response.  Ever have a co-worker or friend that is stressed out all the time? And always sick? Perhaps we can find some new compassion for this person now, because this is the exact mechanism as to why they are stuck in that pattern.  The increased of risk of many health problems due to cortisol-in-control includes but is not limited to:

  • Anxiety
  • Depression
  • Digestive problems
  • Headaches
  • Heart disease
  • Sleep problems
  • Memory and concentration impairment (2)

Final Thoughts

The stress of life is inevitable, but there are so many free resources available to us now to cope with stress and put a proper, realistic system of management in place.  If you find yourself experiencing any of the symptoms associated with H.P.A Axis Dysfunction and/or Adrenal Fatigue, maybe it is time to explore what functional medicine can do for you and your overall health.   

healthyCategoriesAdrenal Health
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How to Stay Healthy During the Holidays

If the holidays are for you, anything like they are for me, then we are bombarded with so many triggers that the last thing we should do is feel terrible over choices that bring us some JOY (and maybe a little comfort?). And if you’re Type-A like me, you want to nail your healing journey on the first round. Does guilt over “indulging” sound familiar?? Let’s be REAL: sometimes the Caymus or Mimi’s cookies call, and you find joy in that moment. CHEERS to you. I like to stick to 6 fundamental principles before heading out to a party, but honestly? Make them your own. Do what makes you happy and lose the food shaming, guilt, anxiety over possible failure, etc.

6 principles I follow to support my Adrenal Fatigue healing journey:

  1. Have a protein shake before I leave the house
  2. Don’t drink coffee before I leave
  3. Eat food with Himalayan pink salt or sea salt
  4. Eat good fats – avocado, coconut oil, wild-caught salmon
  5. Get in my greens
  6. Eat mindfully and frequently

Let’s dive into why these are important and why they work to keep me in check.

Have a protein shake before leaving the house

I’ve been doing this for a long time, and it helps with binge eating and cravings. Start your day with a protein shake – a game-changer! Prepare it with:

  • Your favorite protein powder
  • Almond milk
  • Some spinach or kale – these greens can give you the energy boost you need to tackle the day!

It’s also a quick and easy option if you’re running late for that early family gathering. You can also pack a protein shake in a to-go jar along with some nuts and a piece of fruit if you’re on the move.

No coffee before leaving the house

As much as we love our morning coffee (I’m guilty, too!), it can cause more harm than good during the holidays. Caffeine can leave you feeling anxious and stressed. That’s the opposite of what you need this time of year! If you must, have a cup of joe in the morning. Then, in the afternoon, opt for green tea or ginger tea, which can calm your nerves and improve digestion. If it gets too late in the day, coffee won’t help you wind down or get adequate sleep.

Eat foods with Himalayan pink salt or sea salt

Try this – add a pinch of Himalayan pink salt or sea salt to your food. It can provide electrolytes and trace minerals and help you stay hydrated. Plus, it can help you feel more satisfied with your meals. This will reduce your urge to snack. Yes, these salts have enough trace minerals to help your adrenals recover!

Eat good fats like avocado, coconut oil, wild-caught salmon

Opt for those good fats – avocado, coconut oil, and wild-caught salmon are essential. They are all great sources of healthy fats that help you feel full so you don’t binge. They can provide the necessary energy to:

  • Keep you going
  • Balance your hormones
  • Regulate your blood sugar levels

You can:

  • Add avocado to your salad
  • Replace butter with coconut oil when cooking
  • Have salmon for lunch or dinner for an added boost of omega-3s

Get in those greens

Green veggies – my fav for vitamins, minerals, and antioxidants. Green veggies help your body get the nutrients it needs to heal. Try adding spinach or kale to your protein shake, have a salad as a side with your lunch or dinner, or sauté some broccoli or asparagus as a healthy snack. Can’t stomach “another salad” for lunch? Get some powdered greens to load up on vitamin C! This will assist the adrenals in making adequate levels of hormones.

Eat mindfully and frequently

Eating frequently and mindfully can help reduce stress while maintaining steady energy levels. Don’t indulge in large meals. Instead, try eating smaller, more frequent ones to keep your metabolism up. Take your time eating, chew your food thoroughly, and enjoy each bite. In addition, eating five small meals will stabilize blood sugar. The holidays are not the day to fast all day and binge on a huge feast! Maintaining a healthy lifestyle is tough, especially during the holidays (trust me – I know!). With these six tips, you can make choices that will keep you on track in your Adrenal Fatigue Healing Journey. Remember to listen to your body, be mindful of what you eat, and find time to relax and enjoy the festive season. Happy Holidays, y’all!